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The purpose of this study is to develop a home exercise program for patients 60 years of age and over who are deconditioned following their discharge from the hospital, or recruited from GLA outpatient clinics. The program will be designed to monitor and improve patients' exercise behavior through the use of home technology, such as text messaging monitors.
The aim of this study is to develop and determine the feasibility of implementing a home exercise and functional status monitoring telerehabilitation program, known as TEL-REHAB, for older adults 60 years of age and over who are deconditioned following their discharge from the inpatient setting, or recruited from GLA outpatient clinics. Deconditioning is a modifiable risk factor for preventing institutionalization of frail elderly patients who would otherwise be able to live independently. Home exercise programs are an effective intervention to reduce the risk, but patient compliance with home exercise programs, and assessments of patients during home exercise programs, are barriers to achieving maximal benefits. Face-to-face visits with physical medicine professionals are an effective means to perform these functions, but are problematic because of professional time impacts and patient transportation problems. A TEL-REHAB program will empower these patients to take responsibility for their own health by providing ongoing communication with a healthcare provider. In this way, telerehabilitation may assist older adults to remain independent in their homes as long as possible.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Health Buddy outpatient | Experimental | Received home telehealth monitoring by Health Buddy |
|
| Telephone outpatient | Experimental |
| |
| health buddy inpatient | Experimental |
| |
| telephone inpatient | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Health Buddy, Home telehealth technology | Device | Exercise questions, educational messages, and clinical reminders have been programmed into the home telehealth technology and are administered daily via the Health Buddy(R) to evaluate the program's feasibility based on adherence rates, program completion rates, and safety. |
| Measure | Description | Time Frame |
|---|---|---|
| Exercise Adherence | An 11-week exercise adherence rate was calculated by dividing the total number of days that the participant reported exercising by 77 days and multiplying by 100. This first calculation estimated the exercise adherence rate for the full intervention period regardless of participant dropout. Eleven weeks rather than 12 weeks was used in the denominator because subjects received their HB units some time during the first week of study enrollment and may have missed some days during this first week. | at monthly intervals, for 3-months |
| HB/Phone Adherence | An 11-week text messaging or phone adherence rate was calculated by dividing the number of response days via the HB or phone divided by 77 days and multiplied by 100. This first calculation estimated the text messaging or phone adherence rate for the full intervention period regardless of participant dropout. Eleven weeks rather than 12 weeks was used in the denominator because subjects received their HB units some time during the first week of study enrollment and may have missed some days during this first week. | Monthly over 3 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nancy D. Harada, PhD MPA | VA Greater Los Angeles Healthcare System, West LA | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| VA Greater Los Angeles Healthcare System, West LA | West Los Angeles | California | 90073 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20803390 | Derived | Harada ND, Dhanani S, Elrod M, Hahn T, Kleinman L, Fang M. Feasibility study of home telerehabilitation for physically inactive veterans. J Rehabil Res Dev. 2010;47(5):465-75. doi: 10.1682/jrrd.2009.09.0149. |
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Subjects were recruited from both the inpatient and outpatient settings of a large urban academic VA hospital. Potential participants were recruited through referrals from physicians, case managers, and social workers, participant recruitment fairs, and flyers posted around the hospital.
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| ID | Title | Description |
|---|---|---|
| FG000 | Health Buddy Outpatient | Health Buddy(R), Home telehealth technology : Exercise questions, educational messages, and clinical reminders have been programmed into the home telehealth technology and are administered daily via the Health Buddy(R) to evaluate the program's feasibility based on adherence rates, program completion rates, and safety. |
| FG001 | Telephone Outpatient | |
| FG002 | Health Buddy Inpatient | |
| FG003 | Telephone Inpatient |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Health Buddy Outpatient | Received Health Buddy, recruited from outpatient setting |
| BG001 | Telephone Outpatient | Received telephone counseling, recruited from outpatient setting |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Exercise Adherence | An 11-week exercise adherence rate was calculated by dividing the total number of days that the participant reported exercising by 77 days and multiplying by 100. This first calculation estimated the exercise adherence rate for the full intervention period regardless of participant dropout. Eleven weeks rather than 12 weeks was used in the denominator because subjects received their HB units some time during the first week of study enrollment and may have missed some days during this first week. | Posted | Mean | Standard Deviation | percentage of days adhered | at monthly intervals, for 3-months |
|
3 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Health Buddy Outpatient | Received Health Buddy, recruited from outpatient setting |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Chest tightness | General disorders | Systematic Assessment |
Intervention was developed on a male Veteran population, direct comparisons between groups were formed based on the participant's preference, exercise adherence was based on participants' self reports, small convenience sample.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Nancy Harada, PhD | VA Greater Los Angeles Healthcare System | 310-268-3632 | Nancy.Harada@va.gov |
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| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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|
| Telephone counseling | Other |
|
| BG002 | Health Buddy Inpatient | Received Health Buddy, recruited from inpatient setting |
| BG003 | Telephone Inpatient | Received telephone counseling, recruited from inpatient setting |
| BG004 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
Received telephone counseling, recruited from outpatient setting
| OG002 | Health Buddy Inpatient | Received Health Buddy, recruited from inpatient setting |
| OG003 | Telephone Inpatient | Received telephone counseling, recruited from inpatient setting |
|
|
|
| Primary | HB/Phone Adherence | An 11-week text messaging or phone adherence rate was calculated by dividing the number of response days via the HB or phone divided by 77 days and multiplied by 100. This first calculation estimated the text messaging or phone adherence rate for the full intervention period regardless of participant dropout. Eleven weeks rather than 12 weeks was used in the denominator because subjects received their HB units some time during the first week of study enrollment and may have missed some days during this first week. | Posted | Mean | Standard Deviation | percentage of days adhered | Monthly over 3 months |
|
|
|
|
| 0 |
| 16 |
| 4 |
| 16 |
| EG001 | Telephone Outpatient | Received telephone counseling, recruited from outpatient setting | 0 | 15 | 1 | 15 |
| EG002 | Health Buddy Inpatient | Received Health Buddy, recruited from inpatient setting | 0 | 4 | 3 | 4 |
| EG003 | Telephone Inpatient | Received telephone counseling, recruited from inpatient setting | 0 | 3 | 0 | 3 |
| Dizziness | General disorders | Systematic Assessment |
|
| Trips/Falls | General disorders | Systematic Assessment |
|
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| D001519 |
| Behavior |